To link to the entire object, paste this link in email, IM or documentTo embed the entire object, paste this HTML in websiteTo link to this page, paste this link in email, IM or documentTo embed this page, paste this HTML in website

•J^J/ : .AC '/•/- "
__. -
NORTH CAROLINA
REGISTER
VOLUME 10 • ISSUE 2 • Pages 54 -190
April 17, 1995
IN THIS ISSUE
Executive Orders
Acupuncture Licensing Board
Environment, Health, and Natural Resources
Human Resources
Justice
Labor
List of Rules Codified
Medical Examiners
Real Estate Commission
RRC Objections
Contested Case Decisions
PUBLISHED BY
The Office ofAdministrative Hearings
Rules Division
PO Drawer 27447
Raleigh, NC 27611- 744
7
Telephone (919) 733-2678
Fax (919) 733-3462
Bag *! § fp" ~i \j B» £ 5
E a i; fu^' ^i: J vJ aoakj>
APR 20 1995
KATHRINE R EYERETT
LAW LIBRARY
This publication is printed on permanent, acid-free paper in compliance with G.S. 125-11.13
INFORMATION ABOUT THE NORTH CAROLINA REGISTER AND ADMINISTRATIVE CODE
NORTH CAROLINA REGISTER
The North Carolina Register is published twice a month and
contains information relating to agency, executive, legislative and
ludicial actions required by or affecting Chapter 150B of the
General Statutes. All proposed administrative rules and notices of
public hearings filed under G.S. 150B-21.2 must be published in
the Register. The Register will typically comprise approximately
fifty pages per issue of legal text.
State law requires that a copy of each issue be provided free of
charge to each county in the state and to various state officials and
institutions.
The North Carolina Register is available by yearly subscription
at a cost of one hundred and twenty dollars ($120.00) for 24
issues. Individual issues may be purchased for ten dollars
($10.00).
Requests for subscription to the North Carolina Register should
be directed to the Office of Administrative Hearings, PO Drawer
27447, Raleigh, NC 27611-7447.
ADOPTION, AMENDMENT, AND REPEAL OF RULES
The following is a generalized statement of the procedures to be
followed for an agency to adopt, amend, or repeal a rule. For the
specific statutory authority, please consult Article 2A of Chapter
150B of the General Statutes.
Any agency intending to adopt, amend, or repeal a rule must
first publish notice of the proposed action in the North Carolina
Register. The notice must include the time and place of the public
hearing (or instructions on how a member of the public may
request a hearing); a statement of procedure for public comments;
the text of the proposed rule or the statement of subject matter; the
reason for the proposed action; a reference to the statutory
authority for the action and the proposed effective date.
Unless a specific statute provides otherwise, at least 15 days
must elapse following publication of the notice in the North
Carolina Register before the agency may conduct the public
hearing and at least 30 days must elapse before the agency can take
action on the proposed rule. An agency may not adopt a rule that
differs substantially from the proposed form published as part of
the public notice, until the adopted version has been published in
the North Carolina Register for an additional 30 day comment
period.
When final action is taken, the promulgating agency must file the
rule with the Rules Review Commission (RRC). After approval
by RRC, the adopted rule is filed with the Office of Administrative
Hearings (OAH).
A rule or amended rule generally becomes effective 5 business
days after the rule is filed with the Office of Administrative
Hearings for publication in the North Carolina Administrative
Code (NCAC).
Proposed action on rules may be withdrawn by the promulgating
agency at any time before final action is taken by the agency or
before filing with OAH for publication in the NCAC.
TEMPORARY RULES
Under certain emergency conditions, agencies may issue
temporary rules. Within 24 hours of submission to OAH, the
Codifier of Rules must review the agency's written statement of
findings of need for the temporary rule pursuant to the provisions
in G.S. 150B-21.1. If the Codifier determines that the findings
meet the criteria in G.S. 150B-21.1, the rule is entered into the
NCAC. If the Codifier determines that the findings do not meet
the criteria, the rule is returned to the agency. The agency may
supplement its findings and resubmit the temporary rule for an
additional review or the agency may respond that it will remain
with its initial position. The Codifier, thereafter, will enter the
rule into the NCAC. A temporary rule becomes effective either
when the Codifier of Rules enters the rule in the Code or on the
sixth business day after the agency resubmits the rule without
change. The temporary rule is in effect for the period specified in
the rule or 180 days, whichever is less. An agency adopting a
temporary rule must begin rule-making procedures on the
permanent rule at the same time the temporary rule is filed with
the Codifier.
NORTH CAROLINA ADMINISTRATIVE CODE
The North Carolina Administrative Code (NCAC) is a
compilation and index of the administrative rules of 25 state
agencies and 40 occupational licensing boards. Compilation and
publication of the NCAC is mandated by G.S. 150B-21.18.
The Code is divided into Tides and Chapters. Each state agency
is assigned a separate title which is further broken down by
chapters. Title 21 is designated for occupational licensing boards.
The NCAC is available in two formats.
(1) Single pages may be obtained at a minimum cost of
two dollars and 50 cents ($2.50) for 10 pages or less,
plus fifteen cents ($0.15) per each additional page.
Requests for pages of rules or volumes of the NCAC
should be directed to the Office of Administrative
Hearings.
(2) The full publication and supplement service is printed
and distributed by Barclays Law Publishers. It is
available in hardcopy, CD-ROM and diskette format.
For subscription information, call 1-800-888-3600.
CITATION TO THE NORTH CAROLINA REGISTER
The North Carolina Register is cited by volume, issue, page
number and date. 10:01 NCR 1-67, April 3, 1995 refers to
Volume 10, Issue 1, pages 1 through 67 of the North Carolina
Register issued on April 3, 1995.
t
FOR INFORMATION CONTACT: Office of Administrative Hearings, ATTN: Rules Division, PO Drawer 27447, Raleigh,
NC 27611-7447, (919) 733-2678, FAX (919) 733-3462.
•
NORTH CAROLINA IN THIS ISSUE
I. EXECUTIVE ORDERS
Executive Orders 73-74 .
•
Volume 1 O, Issue 2
Pages 54 - 190
April 17, 1995
This issue contains documents officially
filed through March 31, 1995.
n. IN ADDITION
NPDES Permit
Wildlife Resources Commission Proclamation
54- 55
56
57
Office of Administrative Hearings
Rules Division
424 North Blount Street (27601)
PO Drawer 27447
Raleigh, NC 27611-7447
(919) 733-2678
FAX (919) 733-3462
Julian Mann III, Director
James R. Scarcella St., Deputy Director
Molly Masich, Director of APA Services
Ruby Creech, Publications Coordinator
Teresa Kilpatrick, Editorial Assistant
Jean Shirley, Editorial Assistant
HI. PROPOSED RULES
Environment, Health, and Natural Resources
Sedimentation Control Commission 149 - 150
Human Resources
Medical Assistance 118- 122
Medical Care Commission 58-118
Mental Health, Developmental Disabilities and
Substance Abuse Services 118
Justice
Departmental Rules 122 - 142
Labor
Job Listing Services Act 149
Migrant Housing Act of NC 1 49
Retaliatory Employment Discrimination Act 149
Wage and Hour 142-149
Licensing Boards
Acupuncture Licensing Board 150- 151
Medical Examiners 151 - 157
Real Estate Commission 157 - 166
IV. LIST OF RULES CODIFIED 167-169
V. RRC OBJECTIONS 170
VI. CONTESTED CASE DECISIONS
Index to ALJ Decisions 171 - 175
Text of Selected Decisions
94 CPS 0237 176-178
94 EDC 0533 179-184
95 EHR 0140 185-186
VH. CUMULATIVE INDEX 188-190
NORTH CAROLINA REGISTER
Publication Schedule
(November 1994 - September 1995)
Volume
and
Issue
Number
Issue
Date
Last Day
for
Filing
Last Day
for Elec-tronic
Filing
Earliest
Date for
Public
Hearing
15 days
from
notice
* End of
Required
Comment
Period
30 days
from
notice
Last Day
to Submit
toRRC
** Earliest
Effective
Date
9:15 11/01/94 10/11/94 10/18/94 11/16/94 12/01/94 12/20/94 02/01/95
9:16 11/15/94 10/24/94 10/31/94 11/30/94 12/15/94 12/20/94 02/01/95
9:17 12/01/94 11/07/94 11/15/94 12/16/94 01/03/95 01/20/95 03/01/95
9:18 12/15/94 11/22/94 12/01/94 12/30/94 01/17/95 01/20/95 03/01/95
9:19 01/03/95 12/08/94 12/15/94 01/18/95 02/02/95 02/20/95 04/01/95
9:20 01/17/95 12/21/94 12/30/94 02/01/95 02/16/95 02/20/95 04/01/95
9:21 02/01/95 01/10/95 01/18/95 02/16/95 03/03/95 03/20/95 05/01/95
9:22 02/15/95 01/25/95 02/01/95 03/02/95 03/17/95 03/20/95 05/01/95
9:23 03/01/95 02/08/95 02/15/95 03/16/95 03/31/95 04/20/95 06/01/95
9:24 03/15/95 02/22/95 03/01/95 03/30/95 04/17/95 04/20/95 06/01/95
10:1 04/03/95 03/13/95 03/20/95 04/18/95 05/03/95 05/22/95 07/01/95
10:2 04/17/95 03/24/95 03/31/95 05/02/95 05/17/95 05/22/95 07/01/95
10:3 05/01/95 04/07/95 04/17/95 05/16/95 05/31/95 06/20/95 08/01/95
10:4 05/15/95 04/24/95 05/01/95 05/30/95 06/14/95 06/20/95 08/01/95
10:5 06/01/95 05/10/95 05/17/95 06/16/95 07/03/95 07/20/95 09/01/95
10:6 06/15/95 05/24/95 06/01/95 06/30/95 07/17/95 07/20/95 09/01/95
10:7 07/03/95 06/12/95 06/19/95 07/18/95 08/02/95 08/21/95 10/01/95
10:8 07/14/95 06/22/95 06/29/95 07/31/95 08/14/95 08/21/95 10/01/95
10:9 08/01/95 07/11/95 07/18/95 08/16/95 08/31/95 09/20/95 11/01/95
10:10 08/15/95 07/25/95 08/01/95 08/30/95 09/14/95 09/20/95 11/01/95
10:11 09/01/95 08/11/95 08/18/95 09/18/95 10/02/95 10/20/95 12/01/95
10:12 09/15/95 08/24/95 08/31/95 10/02/95 10/16/95 10/20/95 12/01/95
This table is published as a public service, and the computation of time periods are not to be deemed binding
or controlling. Time is computed according to 26 NCAC 2B . 0103 and the Rules of Civil Procedure, Rule 6.
* An agency must accept comments for at least 30 days after the proposed text is published or until the date
of any public hearing, whichever is longer. See G.S. 150B-21.2(f) for adoption procedures.
** The "Earliest Effective Date" is computed assuming that the agency follows the publication schedule above,
that the Rules Review Commission approves the rule at the next calendar month meeting after submission, and
that RRC delivers the rule to the Codifier of Rules five (5) business days before the 1st day of the next calendar
month.
Revised 10/94
EXECUTIVE ORDERS
EXECUTIVE ORDER NO. 73
SUSPENSION OF RULES
DURING LOCAL EMERGENCIES
WHEREAS, electric service is one of the most essential
services required by modern society, and the public welfare
is immediately threatened by any occurrences, natural or
manmade, which interrupt the delivery of electricity and
electrical services; and
WHEREAS, state and federal regulations prohibit electric
supplier vehicles and commercial motor vehicle drivers from
working extended hours to assist in the repair of damage
and restoration of the delivery of electricity and electrical
services; and
WHEREAS, federal law, specifically 49 C.F.R. Section
390.23, allows a Governor to suspend these rules and
regulations if the Governor determines that an emergency
condition exists.
NOW, THEREFORE, by the authority vested in me as
Governor by the laws and Constitution of the State of North
Carolina, IT IS ORDERED:
Section 1.
Electric supplier vehicles and commercial motor vehicle
drivers are exempt from the rules and regulations restricting
their participation in emergency relief efforts during a "local
emergency." A "local emergency" shall be considered to
be any power outage or interruption of electric service that
occurs within the State of North Carolina, including a near
term threat or occurrence of a meteorological condition or
other condition reasonably likely to result in power outages
or electric service interruption. A "local emergency" begins
when the affected electric supplier receives notice of the
power outage or interruption of electric service or receives
notice of the existence of conditions reasonably likely to
result in power outages or electric service interruption. The
"local emergency" continues until the necessary maintenance
or repair work is completed and personnel utilized to
perform necessary maintenance or repair work have returned
to their respective normal work routines.
This Executive Order is effective immediately.
Done in the City of Raleigh this the 15th day of March,
1995.
EXECUTIVE ORDER NO. 74
DESIGNATING THE YEAR OF THE
MOUNTAINS AND CREATING THE YEAR
OF THE MOUNTAINS COMMISSION
WHEREAS, North Carolina's mountains are among the
state's most valuable and unique assets; and
WHEREAS, North Carolina's mountains merit widespread
appreciation and understanding; and
WHEREAS, growth and change have brought new sets of
opportunities and challenges to people of the mountains; and
WHEREAS, regional efforts and partnerships with the
State are needed to address challenges facing mountain
communities today and in the future; and
WHEREAS, new initiatives for Western North Carolina
can honor and share the culture and history of the mountains
and enhance respect for the natural beauty and environment
of the region while fostering quality growth and develop-ment;
and
WHEREAS, the people of North Carolina's mountains are
pursuing a new vision for the mountains that integrates the
needs of young people, education, technology, industry, and
recreation while protecting the region's resources and
quality of life; and
WHEREAS, the people of North Carolina's mountains
seek to enhance Regional Identity and Recognition, to
cultivate Sustainable Communities, and to promote and
support Mountain Stewardship.
NOW, THEREFORE, by the power vested in me as
Governor by the Constitution and laws of North Carolina,
IT IS ORDERED:
Section 1. Year of the Mountains.
The Year of the Mountains is hereby designated July 1
,
1995 through June 30, 1996.
Section 2^ Establishment.
The Year of the Mountains Commission is hereby estab-lished.
Section 3. Membership and Terms.
The Governor shall appoint 15 persons to serve on the
Commission and shall designate one of its members to serve
as Chair. The Commission shall meet regularly to carry out
its duties at the call of the Chair.
Section 4. Powers and Duties of the Commission.
A. To develop a set of recommendations to effectuate
the purposes of this Order through such activities
as meetings, fact-finding tours, educational events,
and reports.
B. To focus statewide media and public attention on
the mountains to enhance quality growth and
development, protect the natural beauty, and
preserve the culture of the region.
C. To coordinate its efforts with local officials and to
help promote mountain events.
D. To perform and exercise such other duties and
10:2 NORTH CAROLINA REGISTER April 17, 1995 54
EXECUTIVE ORDERS
powers as may be necessary to accomplish the
purposes of this Executive Order.
Section 5^. Administration.
The Governor shall designate an Executive Coordinator to
provide professional assistance and background information
to the Commission, and coordinate its activities. The
Executive Coordinator shall maintain the official minutes
and other records of the Commission, and shall work in
partnership with local and state governmental agencies, the
community college and university system, and the private
nonprofit sector to furnish additional staff assistance,
educational and research materials, and any other adminis-trative
support which the Commission may require.
The Executive Coordinator shall report directly to the
Commission and shall carry out its goals as set forth in the
Commission's mission statement. Members of the Commis-sion
shall receive necessary travel and subsistence expenses
pursuant to N.C.G.S. 138-5. Funding for the Executive
Coordinator and the Commission shall be provided by
DEHNR, the Department of Commerce, the Department of
Cultural Resources, and monies appropriated by the General
Assembly.
The Commission is authorized to accept donations of in-kind
services and funds, subject to the Executive Budget
Act. Western North Carolina Tomorrow (WNCT), a
501(c)(3) nonprofit, has agreed to administer the funds,
including those previously appropriated to it by the General
Assembly.
The Commission shall be considered a "public body" and
its meetings shall be open to the public pursuant to General
Statutes Chapter 143, Article 33C. The Commission, for
administrative purposes only, shall be located in the
Governor's Office.
This Executive Order shall be effective immediately and
expire June 30, 1996.
Done in the Capital City of Raleigh, North Carolina, this
the 27th day of March, 1995.
<
I
i
55 NORTH CAROLINA REGISTER April 17, 1995 10:2
IN ADDITION
STATE OF NORTH CAROLINA
ENVIRONMENTAL MANAGEMENT COMMISSION
POST OFFICE BOX 29535
RALEIGH, NORTH CAROLINA 27626-0535
PUBLIC NOTICE OF INTENT TO ISSUE STATE GENERAL NPDES PERMITS
Public notice of intent to modify State National Pollutant Discharge Elimination System (NPDES) General Permits for Point
Source Discharges of Stormwater associated with the application requirements and clarifications of the visual monitoring
requirements in :
NPDES No. NCGO10000 governing the discharge of stormwater associated with construction activities including clearing,
grading and excavation activities resulting in the disturbance land areas.
On the basis of preliminary staff review and application of Article 21 of Chapter 143 of the General Statutes of North
Carolina, Public Law 92-500 and other lawful standards and regulations, the North Carolina Environmental Management
Commission proposes to modify State NPDES General Permits for the discharges as described above.
INFORMATION: Copies of the draft NPDES General Permits and Fact Sheets concerning the draft Permits are available
by writing or calling:
Bill Mills
Water Quality Section
N.C. Division of Environmental Management
P.O. Box 29535
Raleigh, North Carolina 27626-0535
Telephone (919) 733-5083 ext. 548
Persons wishing to comment upon or object to the proposed determinations are invited to submit their comments in writing
to the above address no later than May 26. 1995 . All comments received prior to that date will be considered in the final
determination regarding permit issuance. A public meeting may be held where the Director of the Division of Environmental
Management finds a significant degree of public interest in any proposed permit issuance.
The draft Permits, Fact Sheets and other information are on file at the Division of Environmental Management, 512 N.
Salisbury Street, Room 925-C, Archdale Building, Raleigh, North Carolina. They may be inspected during normal office
hours. Copies of the information of file are available upon request and payment of the costs of reproduction. All such
comments and requests regarding these matters should make reference to the draft Permit Number, NCG010000.
Date: March 29, 1995
A. Preston Howard, Jr., P.E., Director
Division of Environmental Management
10:2 NORTH CAROLINA REGISTER April 17, 1995 56
IN ADDITION
North Carolina Wildlife Resources Commission
512 N. Salisbury Street, Raleigh, North Carolina 27604-1188, 919-733-3391
Charles R. Fullwood, Executive Director
PROCLAMATION
Charles R. Fullwood, Executive Director, North Carolina Wildlife Resources Commission, acting pursuant to North
Carolina General Statute §113-292 (cl) and authority duly delegated by the Wildlife Resources Commission, hereby declares
that the season for harvesting striped bass by hook-and-line shall close in all waters of the Roanoke River Striped Bass
Management Area downstream of the Edwards Ferry Boating Access Area at US 258 bridge on the Roanoke River in Halifax
County at 12:00 midnight on Sunday April 9, 1995.
In the Roanoke River and its tributaries upstream of the Edwards Ferry Boating Access Area at US 258 bridge
striped bass may be harvested from 12:01 a.m. on Saturdays through 12:00 midnight on Sundays, and from 12:01 a.m.
through 12:00 midnight on Wednesdays. On all other days all striped bass caught, regardless of condition, shall be
immediately returned to the waters where taken and no striped bass may be possessed.
The Roanoke River Striped Bass Management Area is defined as the inland and joint fishing waters of the Roanoke
River and its tributaries, extending from its mouth to Roanoke Rapids Dam, including the Cashie, Middle, and Eastmost
rivers and their tributaries.
This proclamation shall be effective at 12:00 midnight on April 9, 1995 and shall remain in effect until a new
proclamation closing described waters or portions thereof for striped bass fishing is issued.
This proclamation supercedes and replaces all prior proclamations.
NOTES:
a) This Proclamation is issued under the authority of N.C.G.S. §§113-132; 113-134; 113-292; 113-304; and
113-305.
b) All striped bass regardless of condition caught during the closed season shall be immediately returned to
the waters where taken and no striped bass may be possessed.
c) Any person who violates this Proclamation also violates applicable law and is subject to the sanctions
provided by law.
NORTH CAROLINA WILDLIFE RESOURCES COMMISSION
By: Charles R. Fullwood
Executive Director
Date: 4/3/95
57 NORTH CAROLINA REGISTER April 17, 1995 10:2
PROPOSED RULES
TITLE 10 - DEPARTMENT OF
HUMAN RESOURCES
Notice is hereby given in accordance with G.S.
150B-21.2 that the NC Medical Care Commission
intends to repeal rules cited as 10 NCAC 3H .0108 - .0109,
.0206 -.0220, .0306- .0318, .0407 - .0409, .0505 - .0507,
.0510 - .0517, .0605 - .0609, .0705 - .0712, .0810 - .0812,
.0903 - .0911, .1003 - .1008, .1105 - .1109, .1130 - .1136,
.1150 -.1163, .1204- .1208, .1210, .1306- .1308, .1405
- .1406, .1408- .1410, .1501 - .1503, .1612 - .1613, .1703
- .1704, . 1804 - . 1807; and adopt rules cited as 10 NCAC
3H .2001, .2101 - .2110, .2201 - .2212, .2301 - .2308,
.2401 - .2402, .2501 - .2506, .2601 - .2607, .2701, .2801
- .2802, .2901 - .2902, .3001 - .3005, .3011 - .3016, .3021
- .3032, .3101 - .3104, .3201 - .3202, .3301 - .3302, .3401
- .3404.
Proposed Effective Date: September 1, 1995.
A Public Hearing will be conducted at 9:30 a. m. on June
9, 1995 at the Council Building, Room 201, 701 Barbour
Drive, Raleigh, NC.
Reason for Proposed Action: To update state regulations
for nursing homes to be compatible with federal regulations.
Comment Procedures: In order to allow the Commission
sufficient time to review and evaluate your written comments
prior to the hearing, please submit your comments to Mr.
Jackie Sheppard, APA Coordinator, DFS, P. O. Box 29530,
Raleigh, NC 27626-0530, telephone (919) 733-2342 by May
31, 1995, but in no case later than the hearing on June 9,
1995.
Fiscal Note: These Rules do not affect the expenditures or
revenues of local government or state funds.
CHAPTER 3 - DIVISION OF FACILITY
SERVICES
SUBCHAPTER 3H - RULES FOR THE
LICENSING OF NURSING HOMES
SECTION .0100 - GENERAL INFORMATION
.0108 DEFINITIONS
The following definitions will apply throughout this
Subohaptor:
~m "Abuse" moans the willful infliction of physical
pain, injury, mental anguish or unreasonable
confinement whioh may oauoo or result in tempo
rnry or permanent mental or physioal injury, pain,
harm, or death.—Abuse includes, but is not limited
to, the following!
(ft) Verbal abuse—any use of oral, written or gos
-&-
-(e)-
-(d)-
-(e)-
-O)-
-m-
-w-
-&-
-m-
&-
-(*>-
-m-turod
language whioh a reasonable person would
view as disparaging and derogatory tormo to a
patient rogardlooo of his or her ago, ability to
comprehend or disability;
Sexual abuse—sexual harassment, sexual coor
oion or sexual assault of a patient;
Physioal abuse
—
hitting, clapping, kicking or
corporal punishment of a patient;
Mental abuse language or treatment which
would be viewed by a reasonable person as
involving humiliation, harassment, threats of
punishment or deprivation of a patient; —Unreasonable confinement—the separation of a
patient from other persons, or from hio or her
room, against the patient's will or the will of the
patient's legal representative. Unreasonable
confinement does not include emergency—e*
short term monitored separation used as them
poutio intervention to reduoe agitation until a
plan of care is developed to moot the patient's
needs.
"Accident" moans an unplanned or unwanted event
resulting in the injury or wounding, no matter how
slight, of a patient or other individual.
"Adequate"—moans,—when applied—to various
servioos, that the sorvioos are at least satisfactory
in mooting a referred to need when moaaured
against contemporary professional standards of
practice.
"Administrator" means the person who has author
ity for and is responsible for the overall operation
of a facility.
"Appropriate" moans right for the specified use or
purpose, suitable or proper when used as an
adj ective.—When used as a transitive verb it moans
to sot aside for some specified exclusive use.
"Brain injury long term care" is defined as an
interdisc i plinary, intensive maintenance program
for patients who have incurred brain damage
caused by external physical trauma and who have
completed—a primary—course of rehabilitative
treatment and have reaohod a point of no gain or
progress for more than three consecuti ve months.
Services are provided through a medically super
vised interdisciplinary process and are directed
toward maintaining the individual at the optimal
level of physioal, oognitive and behavioral funo
tions .
"Capacity" moans the maximum number of patient
or resident beds for whioh the faoility is licensed
to maintain at any given time.—
"Combination facility" moans a combination home
as defined in G.S. 13 IE 101.
Convalescent care"—means oaro givon for the
purpose of assisting the patient or resident to
regain health or strength.
-(40) "Department" means the North Carolina Depart
10:2 NORTH CAROLINA REGISTER April 17, 1995 58
PROPOSED RULES
-W
-tm-
4U>-
-(B)
processing laundry;
-(G)-
-0*-
disposing of environmental or other waatoo and
pationt or reoident ourgioal or wound dreoo
ings, porsonal care pads or other wastes;
(-B)
—
controlling poets and reporting infectiono and
diseases;
f£) monitor overall environmental/infeotion oontrol
and implementation of safety policies and prooo
(&) monitor—staff development—te
—
assure—active
ongoing insorvioe
—
training at least annually
which shall include universal precautions and
other areas of safety and environmental/infection
oontrol for all personnel; and
(9) aoting on requirements from the Occupational
Safety and Health Administratio&r
Statutory Authority G.S. 13IE- 104.
.0317 REPORTING AND INVESTIGATING ABUSE,
NEGLECT OR MISAPPROPRIATION
(a) The faoility shall take reasonable meaourec to prevent
patient abuse , patient negleot, or misappropriation of patient
property, including but not limited to orientation and
instruction of facility staff on patients' righto, and the
requesting of referenoeo for all prospootivo employees.
(b) The Administrator shall aocuro that the Department is
notified of all alleged incidents which appear to a reasonable
person to bo related to pationt abuse, neglect or misappro-priation
of patient property.—
(o)—The inoident report shall be printed or typed and
postmarked within 48 hours of the alleged inoident. The
report shall be conducted as specified in 42 CFR subsection
4 8 3.13 and shall consist of a simple statement of the
patient's full name ; room number; type of injury, date and
time of the alleged incident of abuse, neglect or misappro
priation of property; names of persons involved; and
immediate aotion tak en by the faoility.
(d) The faoility shall thoroughly investigate and dooument
according to 42 CFR subsection 483.13, whioh is incorpo
rated by reference, including subsequent amendments, all
alleged incidents whioh appear to a reasonable person to be
inoidents of pationt abuoe , pati ent negleot, or misappropria
tion of pationt property and 3hall take whatever steps are
necessary to prevent further incidents of abuse, neglect or
misappropriation of property while the investigation io in
progress.
Authority G.S. 131E-104; 131E-111; 143B-165; 42 U.S.C.
1395; 42 U.S.C. 1396; 42 C.F.R. 483.
.0318 PERSONNEL STANDARDS
(a) The Administrator shall provide for the following;
(4-) numbers and typeo of qualified personnel and
65 NORTH CAROLINA REGISTER April 17, 1995 10:2
PROPOSED RULES
ancil lary—services as necessary—to assure the
health, oafoty and proper oare of pationto and
rooidento;
(3) on duty personnel who for health or other rea
sons present no throat to the health and safety of
pationto and rooidento; and
(3) an individual personnel rooord for eaoh em
ployoo rogardlooo of job assignment Such
rooord shall bo kept current and shall include
oortifioate and licensure numbers, when applioa
bio; the original application with verification of
credentials; periodic performance ovaluationo;
and a signed and dated certification that the
employee hao road and understood the facility' s
polioioo governing conditiono of employment,
including but not limited to on duty dross,
personal hygiene, sleeping on duty, ingestion of
alcohol or other drugs, oonduot towards patients
and rooidento, and the wearing of identification
(b) Each employee shall bo assigned duties consistent with
hio job description and with hio level of education and
training, which includes documented on the job training and
experience and in service education.
Statutory Authority G.S. 131E-104.
SECTION .0400 - PATIENT OR RESIDENT CARE
ASSESSMENT AND PLANNING
.0407 GENERAL
The Administrator shall assure that policies and procedures
are available and implemented for assessi ng each patient's
or resident's health oare noedo and planning for meeting
identified health oare needs. There shall be a oyotem for
evaluating the effectiveness of the assessment, planning and
implementation (delivery of care processes) for each patient
or resident.
Statutory Authority G.S. 131E-104.
.0408 FREQUENCY, METHOD AND CONTENT
OF ASSESSMENT AND PLANNING
Each patient's and resident's condition must bo assessed
on a regular, periodic basis, at least quarterly, with appro
priato notation and updating of the health oare plan.—Heakb
oare planning for eaoh pati ent and resident shall bo an
on going process and must include but may not bo limited
to the following!
(1) data whioh is systematically and continuously
oolleoted about health status;—The data shall be
recorded so as to be accessible and communicated
to all staff involved in the patient's or resident 8
-m- ourront problems and needs identified and priori
tizod from a completed assessment relevant to the
patient' s or resident's response to aging, illness
and his/her general health status; and
—(3) a ourrent plan of oare developed in conjunction
with the patient or resident and/or legal guardian
that includes measurable time related goals and
approaches,—or measures—to bo employed -by
various disciplines in order to aohieve the idonti
fied goals.
Statutory Authority G.S. 131E-104.
.0409 IMPLEMENTATION OF HEALTH CARE
PLAN
All parts of the plan of care shall be assigned to specific
disciplines or staff ao indicated in the plan of oare to assure
that health oare and rehabilitative services are performed
daily and documented for those patients and residents who
required such services.
Statutory Authority G.S. 13IE-104.
SECTION .0500 - NURSING SERVICES
.0505 NURSING/HEALTH CARE
ADMINISTRATION AND SUPERVISION
—(a)
—
A licensed facility shall have a Director of Nursing
service who shall be responsible for the overall organization-and
management of all nursing sorviooo and shall bo
currently licensed to practice as a regi stered nurse by the
North Carolina Board of Nursing in accordance with G.S.
90, Artiole 9A.
(b) The Director of Nursing shall not serve ao Adminio
trator or Assistant Administrator.
(c) A licensed facility, with nursing facilities or combina
tion facilities shall provide a full time Director of Nursing
on duty at least eight hours per day, five dayo a week.—
A
registered nurse shall relievo the Director of Nursing (be in
charge of nursing) during the Director's absence.
(d) A l icensed facility shall employ and aooign registered
nurse , licensed praotioal nurooo and nurse aideo for dutieo in
accordance with G.S. 90, Article 9A.
—(o) The Director of Nursing shall cause the following to
be aooompliohed:
(4-) establishment and implementation of nursing
policies and procedures which shall include but
not bo limited to the following;
(A)
—
assessment of the planning for patiento' nuro
ing oare or health oare needs, and implementa
tion of nursing/health care plans;
(B)
daily charting of any unusual occurrences of
aoute episodes related to patient oare, and
progress notes written monthly reporting eaoh
patient's—performance—in
—
accordance—wkh
identified goals and objectives and each pa
tient's progress toward rehabilitative nursing
goals;
(€)
assurance of the delivery of nursing services in
accordance with physicians' orders , nursing
10:2 NORTH CAROLINA REGISTER April 17, 1995 66
PROPOSED RULES
oaro plans and the facility's poliotoo and prooo
dures;
-(D)
notification of omergenoy phyoioiano or on oall
physicians !
-(E)
infection control to provont cross infection
among pationto and staff shall be in oonfor
monoo with 29 CFR 1910 (Oooupatioool Safety
and Health Standards) which is incorporated by
reference including subsequent amendments.
Emphaoio ohall be placed on oomplianoe with
29 CFR 1910 1030 (Bloodbourne Pathogens).
Copies of Title 29 Part 1910 may bo purchased
from the Superintendent of Documento, U.S.
Governmeat
—
Printing—Offioe ,—Washington,
D.C. 20102 for $3 8 .00 or may bo purchased
with a credit card by telephone to the Govern
mont Printing Office at (202) 7 83 323 8 .
Infection oontrol shall also be in oomplianoe
with the Center of Dioeaoe Control Guidelines
as published by the U.S. Department of Health
and Human Services, Public Health Service
whioh is incorporated by reference including
subsequent amendments. Copies may be
purohaoed from the National Tochnioal Infof
motion Service, U.S. Department of Com
meroe, 5285 Port Royal Road, Springfield,
Virginia, 22161 for $15.95.
-(F)
—
reporting of deaths ;
-(G)
oroorgoncy reporting of fire, patient or staff
accidents or inoidento, or other omergenoy
situations;
-(H)
use of protective devices or restraints to assure
that each patient or resident is restrained 4b
accordance—with phyoioian—orders and the
faoility' s polioies,—and that the restrained
patient or resident i s appropriately evaluated
and released at a minimum of every 2 hours1
,
—(f)
special skin oare and deoubiti core;
—(F)
bowel and bladder training;
-(K)
maintenance of proper body alignment and
restorative nursing care;
-(t)
supervision—of and assisting pationto with
-W-
-m-feeding;
intake and output observation and reporting for
thooe patients whoso condition warrants moni
toring of their fluid balanoe.—This will include
thooe patients on intravenouo fluids or tube
feedings, and patients with kidney failure and
temperatures elevated to 102 degrees F. or
above ;
-m- oatheter oare ; and
-m-
-(0)
procedures used in caring for patients in the
facility,
d evelopment of written job descriptions for
nursing peroonnol;
periodic assessment of the nursing department
with identification of personnel requirements as
they relate to patient oare needs and reporting
-£)-
-&-
-